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WO2010148199A2 - Conversion active d'un circuit monopolaire en un circuit bipolaire à l'aide d'un équilibrage de rétroaction d'impédance - Google Patents

Conversion active d'un circuit monopolaire en un circuit bipolaire à l'aide d'un équilibrage de rétroaction d'impédance Download PDF

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Publication number
WO2010148199A2
WO2010148199A2 PCT/US2010/038991 US2010038991W WO2010148199A2 WO 2010148199 A2 WO2010148199 A2 WO 2010148199A2 US 2010038991 W US2010038991 W US 2010038991W WO 2010148199 A2 WO2010148199 A2 WO 2010148199A2
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WIPO (PCT)
Prior art keywords
circuit
monopolar
electrosurgical
bipolar
electrosurgical generator
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
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PCT/US2010/038991
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English (en)
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WO2010148199A3 (fr
WO2010148199A4 (fr
Inventor
Roy E. Morgan
Wayne K. Ii Auge
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NuOrtho Surgical Inc
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NuOrtho Surgical Inc
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Priority to CA2802664A priority Critical patent/CA2802664A1/fr
Priority to EP10790191A priority patent/EP2442716A2/fr
Publication of WO2010148199A2 publication Critical patent/WO2010148199A2/fr
Publication of WO2010148199A3 publication Critical patent/WO2010148199A3/fr
Publication of WO2010148199A4 publication Critical patent/WO2010148199A4/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206—Generators therefor
    • A61B18/1233—Generators therefor with circuits for assuring patient safety
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206—Generators therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00875—Resistance or impedance

Definitions

  • Embodiments of the present invention relate to the general field of electrosurgical generators that are used to power devices, such as instrument probes, developed for use in surgical and medical procedures.
  • electrosurgical instruments in various types of surgical procedures has become widespread and generally consists of a system whereby a treatment device probe is connected to an electrosurgical generator.
  • the device probe delivers the energy from the electrosurgical generator to the tissue treatment site via electrodes to provide a therapeutic effect.
  • Device probe and electrosurgical generator architecture have been developed for particular therapeutic needs, depending upon, for example, the goals of treatment, the tissue type to be treated, and the treatment environment.
  • electrosurgical generators consist of either monopolar or bipolar configurations, or both, which have become well known in the art.
  • either monopolar or bipolar treatment device probes have been developed to connect to those types of electrosurgical generators via an electrosurgical generator output port, either monopolar or bipolar, respectively.
  • Active (or working) and return (reference) electrodes then function in a variety of ways based upon, for example, configuration, architecture, and connection to the electrosurgical generator.
  • a monopolar or bipolar output portal exists on the electrosurgical generator into which the device probe, either a monopolar or bipolar device respectively, is connected.
  • a monopolar device is connected to a monopolar output portal on the electrosurgical generator and, likewise, a bipolar device is connected to a bipolar output portal on the electrosurgical generator.
  • feedback from the treatment site is then managed by way of the relevant monopolar or bipolar circuitry within the electrosurgical generator and between the device probe electrodes that are connected to the electrosurgical generator accordingly.
  • Such circuitry for this monopolar or bipolar configured output portals is contained within the physical confines of the electrosurgical generator enclosure itself, proximal to the connection of the device probe, and is coupled to an electronic and software controller that monitors said variables and continually checks their time-varying values against preset performance limits. When these performance limits are exceeded, the controlling algorithm forces a safety trip, thus shutting down the primary RF-power output to the working end of the attached device.
  • the specifics of these predefined software controlled trip points is that they are based on the electro physical constraints electrosurgical generator manufacturers have placed on the output portals, which as previously discussed, are configuration specific (monopolar or bipolar).
  • the physical spacing of primary components such as the active (working) and return (reference) electrodes plays a paramount role in what those specific characteristics are that govern said trip points for safety control.
  • An embodiment of the present invention relates to an electronic bridging circuit which includes one or more circuit components arranged in electrical communication with a primary radiofrequency active or reference/return electrode lead of a hand piece of an electrosurgical generator upon which lead a super-imposed rider wave signal is transmitted, the super-imposed wave signal normalized to a monopolar balanced state of feedback to the electrosurgical generator reference plate electrode monitoring circuit via the one or more circuit components; the one or more circuit components selected to affect the super-imposed wave signal by balancing the rider signal; and wherein monopolar outputs of the electrosurgical generator are converted to bipolar outputs compatible with the hand piece upon connection of hand piece with the generator.
  • a plurality of the circuit components can be connected in a parallel configuration, a series configuration, or a combination thereof.
  • the circuit components can include a capacitor, an inductor, a resistor or pluralities and/or combinations thereof. If a capacitor is provided, it can optionally have a value of about 1 picofarad to a value of about 1 microfarad, more preferably about 40 picofarads to a value of about 0.1 microfarad.
  • one or more of the components can be arranged in a bridge circuit.
  • An embodiment of the present invention also relates to an electrosurgical apparatus comprising a conventionally-shaped monopolar output universal plug for the delivery of primary RF electrical current, which comprises no more than two of the typical three conductors.
  • An embodiment of the present invention also relates to a method for converting a monopolar electrosurgical generator which outputs a power wave and a super-imposed rider wave for use in a bipolar electrosurgical configuration which method includes bridging leads connected to the monopolar electrosurgical generator with a bridging circuit having at least one balancing component, the balancing component selected such that the impedance encountered by the rider wave when traveling through a bipolar hand piece and the balancing component is substantially similar to the impedance encountered by the rider wave when a monopolar hand piece and return pad is connected to the electrosurgical generator.
  • the balancing component can be disposed within the bipolar hand piece.
  • the balancing component can comprise a plurality of components which can be active, resistive, or a combination thereof.
  • the bipolar hand piece can be electrically connected to only one of the cut or coagulate outputs of the monopolar electrosurgical generator.
  • An embodiment of the present invention also relates to a method for using a monopolar output of an electrosurgical generator for a bipolar electrosurgical application which method includes connecting a plurality of active electrodes of a bipolar electrosurgical hand piece to an active electrode port of a monopolar electrosurgical generator; providing one or more components through which a reference signal passes, the one or more components selected such that the total impendence encountered by the reference signal is at least substantially similar to a total impedance which would be encountered by the reference signal if it were traveling through a functioning monopolar electrosurgical hand piece.
  • At least one of the plurality of active electrodes can be connected to the active electrode port of the monopolar electrosurgical generator through a switch.
  • each of a plurality of the active electrodes can be connected to the active electrode port of the monopolar electrosurgical generator through respective switches. The plurality of active electrodes can be individually and/or simultaneously activated.
  • An embodiment of the present invention relates to an electrosurgical apparatus which includes a monopolar electrosurgical generator connected to a bipolar electrosurgical hand piece.
  • the hand piece can operate in a cut only mode or in a coagulate only mode.
  • An embodiment of the present invention also relates to a bipolar electrosurgical hand piece connectable and operable with a monopolar electrosurgical generator.
  • the electrosurgical hand piece of each of the foregoing embodiments can be operable in-situ and optionally with a liquid environment about a tip of the hand piece.
  • FIG. 1 A is a drawing which illustrates the prior art traditional method of delivering monopolar high frequency electrical current to the human body during a treatment procedure
  • FIG. 1 B is a drawing which illustrates the circuit bridge according to one embodiment of the present invention for use with a traditional electrosurgical generator whereby the bridge is within the device and its connector to the electrosurgical generator creating a bipolar circuit based device connected to the monopolar electrosurgical generator;
  • Fig. 2A is a drawing which illustrates an alternative placement of the preferred embodiment of active bridge components within the electrosurgical circuit outside of the electrosurgical generator;
  • Fig. 2B is a drawing which illustrates an alternative embodiment depicting how the bridging circuit interacts with the return (reference) or sensing circuit;
  • FIG. 3 is a drawing which illustrates a preferred embodiment for the bridge circuit in which the connector terminal of the active (working) or return (reference) lead-wire is bridged with the necessary components for circuit matching;
  • Fig. 4 is a graphical representation of the characteristic impedance threshold limits and operational envelope of the preferred embodiment within existing safety envelopes of typical electrosurgical generators;
  • FIG. 5 is a drawing which schematically illustrates an embodiment of the present invention wherein a single active electrode is connected to a single switch;
  • Fig. 6 is a drawing illustrating a universal connector as can be modified in accordance with the teachings of one embodiment of the present invention
  • Fig. 7 is a drawing which schematically illustrates an embodiment of the present invention wherein a plurality of electrodes are connected to a plurality of switches;
  • Fig. 8 is a drawing which schematically illustrates an embodiment of the present invention wherein a plurality of active electrodes are connected to a single switch.
  • the present invention allows the general field of electrosurgery to use electrosurgical generators to power devices, such as instrument probes, developed for use in surgical and medical procedures.
  • the present invention relates to specific methods of connection of such devices to electrosurgical generators that provide active enhancement of output signal monitoring.
  • Embodiments of the present invention also relate to specific management of circuit characterization when a single mode output from an electrosurgical generator is bridged to perform a circuit contraction in physical space.
  • the elements described herein relate generally to any electrosurgical generator that employs an active feedback monitoring algorithm designed to measure Voltage Standing Wave Ratio's (VSWR), total impedance change ( ⁇ Z), current fluctuation threshold/change ( ⁇ l), peak to peak voltage change or time-averaged voltage change ( ⁇ V) and other similar manipulations of the variables of Ohm's Law as it applies to radio-frequency transmission circuits into loads of time-varying overall impedance.
  • VSWR Voltage Standing Wave Ratio's
  • ⁇ Z total impedance change
  • ⁇ l current fluctuation threshold/change
  • ⁇ V time-averaged voltage change
  • Embodiments of the present invention are also useful to the general field of electrosurgery in which electrosurgical generators are used to power devices, such as instrument probes, developed for use in surgical procedures.
  • One or more embodiments of the present invention disclosed herein expands the functionality of the output ports of an electrosurgical generator through a bridging configuration that spatially contracts the heretofore separated independent poles of a monopolar system.
  • the bridging approach places the previously separated return (reference) electrode (commonly referred to as a return pad) in close proximity to the active (working) electrode through a reconfiguration of the connected device probe's circuitry.
  • passive and/or active electrical components are preferably employed in the completion of the bridge circuit to provide a rebalancing of the VSWR, Ztot, Imax, V pp or similar control variable that is typically contained and monitored within the electrosurgical generator to provide safety feedback trip points for primary electrosurgical power output shutdown.
  • the new bridge components are positioned in a way so as to act as bridge circuit maximum or minimum limits to activation based on the nominal variable of Ztot as measured between the output port of the electrosurgical generator and the active (working) end of the connected device probe.
  • components used in the bridging circuit of the device may be selected to specifically mate with a specific type of electrosurgical generator and its corresponding control algorithm depending on the variable to which the specific generator is tuned.
  • the present invention can optionally be incorporated into an electrosurgical system that works in concert with specific instrumentation designed to take advantage of the bridge circuit configuration and reconfigured to work in a complementary manner from the electrosurgical generator output port to which it is attached.
  • this allows a) bipolar probe function from the monopolar output port of any given electrosurgical generator (termed the "primary” approach) and b) a reverse splitting of a bipolar output port into a monopolar output port or device is also enabled (termed the "reverse” approach).
  • the primary approach will be discussed in more detail below with the understanding that the reverse approach will be subsequently obvious to those skilled in the art after studying this application.
  • Fig. 1 A illustrates the prior art's traditional method of delivering monopolar high frequency electrical current to the human body.
  • the electrosurgical generator 40 is driven by AC- mains power and inductively coupled to the primary electrosurgical output power circuit 15.
  • the primary electrosurgical output power circuit is electrically coupled to the monopolar hand piece device probe 10 and delivers electrosurgical current to the surgical site when manually directed by the hand of the surgeon on the device activation switch.
  • the electrosurgical current then passes through the conductive media of the human tissues 30, whereupon it is typically routed by path of least resistance to the return electrode pad / plate 20 and returned to the electrosurgical generator return (reference) electrode via coupling cable 25.
  • the electrosurgical current is passed from one pole (the active or working) to the second pole (the return or reference) at frequencies that range from 400 kHz to 1GHz among others.
  • Current passing through the human tissue zone 30 is not capable of being controlled to any extent by any portion of the electrosurgical system, except to start and stop the current flow itself.
  • the dispersion and relative current density at any given point within the human tissues 30 is random and preferential to higher conductive tissues or electrical tissue reservoirs. As such, it is not uncommon for monopolar methods of electrosurgery to result in tissue burns within zone 30 resulting in tissue effects not associated with the intended surgical site.
  • Fig.1 B illustrates the circuit bridge of the present invention for use with a traditional electrosurgical generator whereby the bridge enables the ability to use a bipolar device in a monopolar output port of an electrosurgical generator.
  • the electrosurgical generator circuit is nominally represented by a typical high-frequency transmission line. It therefore follows that such a high frequency transmission line can be modeled effectively through the use of the characteristic impedance equation:
  • G overall circuit transmission line conductance
  • a typical electrosurgical generator transmission line consists of either closely spaced twisted-pair wires, straight-pair wires, or coaxial cable wires
  • the actual conductors of the overall circuit leads to a highly capacitive circuit orientation.
  • the typical arrangement of the return electrode pad used universally in monopolar surgical configurations of the circuit forces an additional capacitive element if there is more than one electrical conductor used to provide the return pathway to the reference point.
  • the variables with the greatest fluctuations intraoperativly when in use are a) the distance of the active (working) electrode to the surgical site, b) the conductivity of the interfacing media, c) the resistance of the active electrode (influenced by thermal properties; heat), and d) time-relative denaturation of tissue at the surgical site (related to conductivity of the interfacing media).
  • the overall electrical parameters of those components of the system which are not immersed in the interfacing media at or near the surgical site tend to remain relatively constant by comparison.
  • Eq. 1 in terms of those parameters that apply most prominently when operating the device to the characteristic impedance as:
  • RQ resistance (change) at a specific distance from the surgical site (monopolar only)
  • Rt resistance change due to thermal heating of the active electrode
  • k conductivity of the specific interfacing media
  • A microscopic surface area (geometric area* roughness factor) of the active electrode
  • d distance between the active and return electrode
  • Fig. 1 B illustrates how the circuit bridging component can be bridged from the active RF output circuit to the primary return circuit in order to establish a "matched" impedance of the circuit to the load when the monopolar mode electrosurgical generator output port is bridged into the bipolar mode of the device, resulting in the elimination of the traditional return pad.
  • This simple elimination requires that the external circuit within the device configuration be matched anew to the electrosurgical generator sensing pattern such that it will operate according to the standard output curves prescribed by the electrosurgical generator.
  • the matched impedance can be achieved for a bipolar device to function normally from the monopolar outputs of a traditional monopolar electrosurgical generator.
  • chondrocyte collateral damage is very notable with current devices of the prior art as the ability to control energy deposition with a monopolar device is limited.
  • the return sequence of the traditional circuit obviates the ability to limit current deposition in the surrounding healthy areas.
  • a bipolar device can be configured to be powered by a monopolar electrosurgical generator. This advantage eliminates the safety risk of prior art systems for energy deposition to collateral tissue and also eliminates the need for a bipolar electrosurgical generator as a power source. Further, the large spectrum of power settings and other configuration variables within a monopolar electrosurgical generator can be now applied to bipolar devices for further treatment flexibility that is enhanced with the fine tuning of energy delivery.
  • bridge elements 100 can include any one or a combination of the types of components shown, which include but are not limited to capacitance (capacitors), inductance (inductors), resistance (resistors), signal amplification (op-amps), over-current protection (fuses, links, etc.), and other circuit components known to those skilled in the art.
  • capacitors capacitors
  • inductance inductors
  • resistance resistor
  • op-amps signal amplification
  • over-current protection fuses, links, etc.
  • bridge components may be added between the active output line 15, and the parallel sensing circuit and the return (reference) electrode line 25.
  • This parallel sensing circuit is most often implemented as a "rider" signal on one of the primary power lines; either output or return (reference) and is denoted as element 90.
  • This sensing circuit is typically filtered from the primary RF power signal and is used to determine the condition of the relative circuit impedance compared to the load impedance and is typically designed to "trip" when the two impedances become significantly imbalanced, indicating a fault condition in some part of the overall delivery circuit. In most cases such an imbalance is caused by a short or open circuit condition that evolves due to detachment of some element within the overall system such as, the return pad.
  • the method of creating the bridging circuit allows for a single device 10 (as labeled in Fig. 1A), to now utilize the output of a monopolar port from an electrosurgical generator and bridge the distance 110, of the human tissues through which monopolar treatment current typically flows to the return pad.
  • This joining of the active (working) 15 and return (reference) 25 electrodes in a single conductor has the benefit of expanding the use of the traditional electrosurgical generator consoles in ways that have been lacking until now.
  • the pairing of the two primary conductors combined with the simultaneous elimination of the return pad is a net removal of active component influence from the overall electrosurgical generator system. The result is that in the bridging circuit, the same influence of active components must be restored in order to achieve a matched circuit into load condition.
  • the communication of the active components is not actually with the primary electrosurgical generator power output, but rather with a super-imposed "rider" signal that is typically used to monitor overall electrosurgical system conditions intra-operatively.
  • This "rider” signal is typically conducted along the same conductors used for the primary electrosurgical power output but is graphically depicted as a separate conductor 90, for clarity of understanding in separating a super-imposed electrical high-frequency signal from the underlying power output signal.
  • the physical connection of active components 100 may be between the active (working) and return (reference) electrodes or pairs of either active (working) or return (reference) electrode leads, the values chosen for these components are not capable of exerting significant influence on the primary output waves of the high-power signal.
  • the lower power "rider" wave however, is strongly influenced by these elements and as such is held in the matched state barring any significant changes at the working end of the bridged bipolar device 10.
  • several electrode pairs can be designed whereby each electrode pair has its own bridge circuit characteristics so that the device can operate in a multimodal fashion.
  • the multimodal fashion can be of any number of configurations, such as having the electrode pairs activated with their own switch on the device handle or that each electrode pair is activated differently based upon its position on the device.
  • Fig. 2A illustrates an alternative placement of the preferred embodiment of active bridge components within the device electrosurgical circuit.
  • the bridge circuit elements 50, 60, 70 are preferably arranged in a parallel manner to provide a greater influence to the return (reference) electrode for each element of the circuit.
  • the bridge circuit is created from parallel elements and is completed proximal of the hand piece 10 but distal to the electrosurgical generator.
  • This embodiment illustrates how the traditional return pad is now eliminated while maintaining the matched condition of the overall circuit to the load encountered within the surgical site. It also demonstrates the multimodal configurations that can be incorporated into the device design based upon varying bridge circuitry per electrode pairs.
  • Fig. 2B illustrates additional compositions and methods of use of an embodiment, wherein the interaction of the bridging circuit is directly with the theoretical sensing circuit line which provides for matching between the return (reference) line(s) to the electrosurgical generator output ports.
  • the arrangement of bridge circuit 100 as shown can be in a parallel configuration, a series configuration, or any combinations thereof. While the physical connection of the components is preferably to the primary return (reference) or active (working) electrode lead lines, the effective communication of the bridging circuit is preferably with the "rider" frequency wave that is sent in a super-imposed manner along the same transmission lines, but measured via filtered sensing in an alternative test circuit to establish trip parameters for safe operation of the electrosurgical generator.
  • Fig. 2B also demonstrates the multimodal configurations that can be incorporated into device design based upon varying bridge circuitry per electrode pairs.
  • Fig. 3 is a detailed illustration of the preferred embodiment for the bridge circuit in which the connector terminal of the active (working) or return (reference) lead-wire is bridged with the necessary components for circuit matching.
  • the dual wires are often used to conduct high-frequency "rider" signals that are measured or monitored in fault detection circuits for open, short, or high impedance conditions that signal undesirable surgical conditions.
  • This signal is bridged with active components 50, 60, 70 to provide a matched circuit within a single jacketed conductor 130.
  • Matching components can be placed at any point along the conducting pair to enhance or ameliorate the effects of linear resistance, capacitance, and/or inductance as the circuit may embody per unit length.
  • Fig. 4 is a graphical representation of the characteristic impedance threshold limits and operational envelope of the preferred embodiment within existing safety envelopes of typical electrosurgical generators. With respect to increasing capacitance up to or beyond the matched load condition of curve 150, there is no change in the point at which the electrosurgical generator sensing circuit will detect that the characteristic impedance of the overall output circuit has been exceeded. Threshold 140 is typically governed by a non-linear software algorithm that seeks to maintain a maximum voltage output, maximum current flow, at a minimum deviation from a user-selectable output value.
  • the bridging circuit operation is designed to provide an impedance matching equivalent circuit as seen by the output ports of a traditionally monopolar electrosurgical generator. Since no internal components of the electrosurgical generator are affected by this invention, the matching that the bridge circuit provides has no effect on the normal safety parameters of the electrosurgical generator and by definition forces the attached device containing the bridge circuit to operate within the safety envelope of the electrosurgical generator to which it is attached. This is clearly illustrated mathematically when the reduced version of equation 2b, shown as equation 3, is reviewed as shown below:
  • V u_ M V u_ M .
  • c a constant inductance
  • a bridging circuit opens up new and more expansive uses for the power-outputs and associated wave-forms of those power outputs from monopolar electrosurgical generators that can now be employed in a bipolar manner, thus enabling broader treatment options for the wide variety of human tissues encountered in most surgical specialties.
  • the bridge circuit for joining of monopolar outputs into a single bipolar device may be completed via multiple means, which include but are not limited to connector terminal bridging, conductor cable bridging with flexible circuit components, and bipolar hand-piece bridging with a variety of PCBA approaches.
  • Fig. 5 schematically illustrates an embodiment of the present invention wherein a conducting portion of bipolar electrosurgical probe 200 is electrically connected to switch 202 and wherein another conducting portion of bipolar electrosurgical probe 200 is electrically connected to component 204.
  • component 204 most preferably bridges a plurality of connectors of the return cable connector 206.
  • Component 206 is most preferably selected to have a value such that a monopolar electrosurgical generator unit detects an impedance, when used with bipolar electrosurgical unit 200, which impedance is substantially similar to that encountered when a monopolar electrosurgical probe is used with the generator.
  • component 206 can comprise an inductive value, a capacitive value, a resistive value, and/or combinations thereof, depending upon the generator to which bipolar electrosurgical probe 200 is connected.
  • component 206 can be a variably- adjustable component or plurality of variably-adjustable components such that a user can adjust the one or more components 206 to create an overall probe impedance which is substantially similar to that of a monopolar probe connected to the generator.
  • Universal Connector 300 which is configured with 3-pole contacts 302 as illustrated in Fig. 6.
  • the purpose of these connector poles is to provide dual functionality of cutting and coagulation at the distal tip of the working device.
  • wiring connected to each of the poles in the connector are routed to a collocation point where the individual wires are then bundled together through an insulating/protective jacket where they are further routed to the hand piece along a roughly 3-meter length of cabling.
  • the circumstantial configuration of the cabling leads to several electrodynamic functions that must be compensated for when using a bridging-circuit approach in the conversion of a traditional mono-polar circuit to a bi-polar circuit.
  • the present invention comprises a conventionally-shaped universal connector which comprises only two of the typical three conductors. Accordingly, in one embodiment, the present invention comprises a conventionally-shaped universal connector which has only two conductors disposed therein and, of which, one conductor(s) are for the common (reference) conductor and the remaining conductor used is placed in either the coagulation conductor location or in the cutting conductor location. In an alternative embodiment, a conventional universal connector is provided with all three of the conductors, however, only two of the three conductors are electrically connected to the cabling leading to the hand piece.
  • the phenomenon is a function of the propagated electro-magnetic wave that is inadvertently "tuned” to an antenna of approximately 3-4 meters.
  • a cable of the same length acts as an ideal "antenna” and receives these signals that subsequently generate spurious currents on the third pole and its corresponding wire.
  • Spurious currents can have several detrimental effects when uncontrolled or ignored within the system of operation. In the case of the prior art, there exists the chance of control function triggering signals being overridden by antenna effect currents. Additionally, there exists a reverse condition, wherein the electrosurgical generator port that is not intended for use can, through capacitive coupling, conduct its output energy in a variable manner to the working end of the hand piece.
  • An improved method of achieving the desired output at the distal tip of the device is to remove the secondary higher energy conductor (i.e. the cutting conductor) thereby ensuring that no spurious currents are induced in an uncontrolled manner to the distal end of the device or to the electrosurgical generator that could destabilize operation.
  • the present invention preferably uses only two of the typical three outputs of universal connector 300. Accordingly, in one embodiment, the present invention uses only the common conductor and either the cutting output conductor or the coagulation output from a monopolar electrosurgical generator.
  • Embodiments of the present invention eliminate the need for a dual function control mechanism through the advancement in understanding of distal tip electrode geometry and surface area relationships between the active and return electrode. This improvement provides for sufficient energy concentrations at the active electrode to be built up such that performing surgery across a broader range of power effect levels/functions is possible without the need of a different power output portal.
  • the bridging circuit of the present invention also requires the elimination of at least one of the primary power output conductors of the universal connector to provide the preferred embodiment of lower energy level operations whilst simultaneously producing equivalent surgical effects to those devices of the prior art. It is through the use of and amplification of surgical effect in the lower energy bands of RF electrosurgical power output that tissue is thereby preserved and protected from exposure to excessive current or heat. The resulting surgical effect is the ability to perform traditional underwater surgery at power levels previously thought insufficient to perform surgical procedures from the coagulate only mode.
  • a plurality of active electrodes can optionally be provided which electrodes can optionally be connected to a single switch or to a plurality of switches such that each active electrode can be simultaneously or selectively activated.

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Abstract

L'invention porte sur des systèmes, des dispositifs et des procédés pour une électrochirurgie, dans lesquels un pont de circuit est créé pour un circuit électrochirurgical monopolaire qui fournit une impédance adaptée à une condition de charge, reliant ainsi les conducteurs d'électrode actif (travail) et de retour (de référence) en un unique dispositif à mode bipolaire.
PCT/US2010/038991 2009-06-17 2010-06-17 Conversion active d'un circuit monopolaire en un circuit bipolaire à l'aide d'un équilibrage de rétroaction d'impédance Ceased WO2010148199A2 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
CA2802664A CA2802664A1 (fr) 2009-06-17 2010-06-17 Conversion active d'un circuit monopolaire en un circuit bipolaire a l'aide d'un equilibrage de retroaction d'impedance
EP10790191A EP2442716A2 (fr) 2009-06-17 2010-06-17 Conversion active d'un circuit monopolaire en un circuit bipolaire à l'aide d'un équilibrage de rétroaction d'impédance

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US12/486,616 2009-06-17
US12/486,616 US20100324550A1 (en) 2009-06-17 2009-06-17 Active conversion of a monopolar circuit to a bipolar circuit using impedance feedback balancing

Publications (3)

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WO2010148199A2 true WO2010148199A2 (fr) 2010-12-23
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CA2802664A1 (fr) 2010-12-23
EP2442716A2 (fr) 2012-04-25
WO2010148199A3 (fr) 2011-03-31
WO2010148199A4 (fr) 2011-05-19
US20100324550A1 (en) 2010-12-23

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